Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.
Several recent court cases illustrate how some states are attempting to mandate physician reporting of all underage sexual activity as instances of child abuse.
Melissa Weddle, MD, MPH and Patricia K. Kokotailo, MD, MPH
Physicians should honor confidentiality whenever possible when screening and treating adolescents for sensitive health conditions such as substance abuse.